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Clare Harley, Elena Takeuchi, Sally Taylor, Ada Keding,

A mixed methods approach to adapting health related quality of life measures for use in routine oncology clinical practice. Clare Harley, Elena Takeuchi, Sally Taylor, Ada Keding, Kate Absolom , Julia Brown and Galina Velikova. Ada Keding. Background.

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Clare Harley, Elena Takeuchi, Sally Taylor, Ada Keding,

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  1. A mixed methods approach to adapting health related quality of life measures for use in routine oncology clinical practice Clare Harley, Elena Takeuchi, Sally Taylor, Ada Keding, Kate Absolom, Julia Brown and Galina Velikova Ada Keding

  2. Background • Benefits of routine HRQOL assessment: • Improved communication • Increased awareness of patient concerns • Improved patient well-being • However, not routinely implemented in oncology clinical practice • Possible barriers : • Lack of disease and treatment specificity • Research vs Clinical target

  3. Aims • To adapt HRQOL measures specifically for use in chemotherapy clinical practice • Breast Cancer • Gynaecological Cancer • Colorectal Cancer • Use of qualitative and quantitative methods

  4. Stages of Development

  5. Stage 2: Content Analysis

  6. Stage 3: Operationalisation • Most issues covered by • EORTC QLQ generic and disease specific module items • Issues relating to stoma not routinely discussed, covered by • EORTC QLQ colorectal modules • FACT-C • Commonly discussed items missing • Sore Mouth • Infection • Weight • Neuropathy • Sore Eyes • Dizziness • Covered by • EORTC Item Bank • Rotterdam Symptom Checklist

  7. Stage 4: Pre-Testing by Interviews • Appropriateness • Understandable and not found upsetting • Sexual questions made optional • Item refinement • Removal of duplicates and non-useful items • Additional items covering Emotional Distress • Issues in clinical practice • Need for guidelines • Clear referral pathways

  8. Stage 5: Pilot Population

  9. Stage 5: Factor Analysis Sexual Function 6 items Stoma 4 items 16-22 single items

  10. Stage 5: Item Reduction α / best α Prevalence Factor Loading Factor Co-Loading Score Spread Patient Rating Disease Specificity Doctor Rating Clinical Utility Validated Scales

  11. Stage 5: Known Groups

  12. Conclusions and Next Steps • Value of mixed methods • Identified gaps • Facilitated decision making during item selection • Provided insights into clinical practice and barriers to uptake of HRQOL measures • Study under way: Doctor Training pilot

  13. We would like to thank all patients and clinical staff who have been giving their time to take part in our research. Any questions?

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